AB0626 Prevalence of Frailty in an Internet-Based Cohort with a Self-Reported Diagnosis of Vasculitis – The VascStrong Study
Authors: S. E. Sattui, J. Stadler, C. Burroughs, K. Larson, P. A. Merkel, R. Spiera
Journal: Annals of the Rheumatic Diseases (2022)

Background Frailty is a syndrome characterized by an increased vulnerability to stressors and is associated with disability and early mortality. Frailty may be accelerated in patients with vasculitis. The prevalence of frailty in patients with vasculitis remains unexplored. Objectives To describe the prevalence of self-reported frailty in patients with vasculitis. Methods VascStrong is a longitudinal study utilizing the Vasculitis Patient-Powered Research Network (VPPRN), an internet-based prospective longitudinal cohort. Data elements collected included type of vasculitis, demographic, and use of medications. Frailty was measured by the FRAIL scale, a self-report measure which queries on 5 domains: 1. Fatigue, 2. Resistance (inability to climb 10 stairs), 3. Ambulation (inability to walk several blocks), 4. Illnesses (≥5/11 comorbidities), and 5. Loss of Weight (≥5% weight loss in the last year). Patients were classified as robust, pre-frail, and frail based on 0, 1-2, or ≥ 3 criteria, respectively. Results The survey collected information from October 8, 2021-January 15, 2022. For this preliminary analysis, 228 responses were included. Clinical characteristics and study data are outlined in Table 1. Prevalence of robustness, pre-frailty, and frailty was 28.5%, 47.8%, and 23.7%, respectively. The majority of patients with each form of vasculitis were rated as frail or pre-frail. Among the individual FRAIL domains, fatigue and loss of weight were the most frequent (48.7% and 42.5%, respectively) while illnesses, was the least common (3.5%). When compared to robust patients, frail and pre-frail patients were younger, more frequently female, more likely to be obese and reported more frequent use of glucocorticoids. Patients with urticarial vasculitis and Takayasu’s arteritis were more commonly pre-frail or frail, compared to patients with other types of vasculitis. Table 1. Characteristics for overall cohort and by frailty classification Overall N = 228 Robust N = 65 Pre-frail N = 109 Frail N = 54 Age, years, mean (SD) 57.6 (15.3) 62.4 (14.8) 55.1 (15.6) 57.1 (14.3) Sex, female 163 (71.5%) 40 (61.5%) 84 (77.1%) 39 (72.2%) Race, white 204 (89.5%) 60 (92.3%) 98 (89.9%) 46 (85.2%) Ethnicity, non-Hispanic 195 (85.5%) 57 (87.7%) 97 (89.0%) 41 (75.9%) Disease duration, years, mean (SD) 8.5 (7.9) 8.6 (6.8) 8.4 (8.4) 8.8 (8.0) Employment status Employed 98 (43.0%) 24 (36.9%) 60 (55.0%) 14 (26.0%) Retired 66 (28.9%) 29 (44.6%) 24 (22.0%) 13 (24.1%) Disabled (unable to work) 34 (14.9%) 4 (6.2%) 12 (11.0%) 18 (33.3%) Other/missing 30 (13.2%) 8 (12.3%) 13 (12.0%) 9 (16.7%) Diagnosis Granulomatosis with polyangiitis 89 (100.0%) 29 (32.6%) 42 (47.2%) 18 (20.2%) Eosinophilic granulomatosis with polyangiitis 26 (100.0%) 9 (34.6%) 11 (42.3%) 6 (23.1%) Microscopic polyangiitis 23 (100.0%) 7 (30.4%) 12 (52.2%) 4 (17.4%) Giant cell arteritis 17 (100.0%) 5 (29.4%) 8 (47.1%) 4 (23.5%) Urticarial vasculitis 14 (100.0%) 2 (14.3%) 5 (35.7%) 7 (50.0%) Takayasu's arteritis 10 (100.0%) 0 (0%) 7 (70.0%) 3 (30.0%) Other* 49 (100.0%) 8 (26.5%) 16 (49.0%) 8 (24.5%) Body Mass Index a Underweight 6 (2.6%) 2 (3.1%) 4 (3.7%) 0 (0%) Normal 86 (37.7%) 35 (53.8%) 40 (36.7%) 11 (20.4%) Overweight 63 (27.6%) 19 (29.2%) 29 (26.6%) 15 (27.8%) Obese 73 (32.0%) 9 (13.8%) 36 (33.0%) 28 (51.9%) Currently on glucocorticoids 104 (45.6%) 19 (29.2%) 52 (47.7%) 33 (61.1%) Current glucocorticoid dose, prednisone equivalent (mg/d), mean (SD) 13.1 (18.0) 12.6 (17.1) 11.3 (18.6) 16.4 (17.4) Data presented as n (%), unless specified otherwise *Other diagnosis: Behçet’s disease, primary angiitis central nervous system, cryoglobulinemic vasculitis, IgA vasculitis, polyarteritis nodosa, and other/suspected diagnosis a Based on World Health Organization Body Mass Index categories Conclusion Self-reported frailty or pre-frailty is prevalent in the majority of patients with multiple forms of vasculitis. Future analysis will focus on identifying factors associated with frailty in patients with vasculitis, to allow earlier identification and prevention in this population at high-risk for frailty. Acknowledgements The investigators want to thank all participants. Disclosure of Interests Sebastian E. Sattui Grant/research support from: receives research funding related to clinical trials by AstraZeneca (MANDARA), John Stadler: None declared, Cristina Burroughs: None declared, Kalen Larson: None declared, Peter A. Merkel Consultant of: CSL Behring, Dynacure, EMDSerono, Immagene, Jannsen, Kiniksa, Kyverna, Magenta, MiroBio, Mitsubishi, Novartis, Pfizer, Regeneron, Sparrow, Talaris, AbbVie, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Neutrolis, Takeda., Grant/research support from: AbbVie, AstraZeneca, Boeringher-Ingelheim, Bristol-Myers Squibb, ChemoCentryx, Forbius, Genentech/Roche, Genzyme/Sanofi, GlaxoSmithKline, InflaRx, Neutrolis, Takeda., Robert Spiera Consultant of: Chemocentryx, Grant/research support from: Chemocentryx